Estimation of thigh muscle mass with magnetic resonance imaging in older adults and people with chronic obstructive pulmonary disease

Background and Purpose Quantifying muscle mass is an essential part of physical therapy assessment, particularly in older adults and in people with chronic conditions associated with muscle atrophy. The purposes of this study were to examine the relationship between muscle cross-sectional area (CSA) and volume by use of magnetic resonance imaging (MRI) and to compare anthropometric estimations of midthigh CSA with measurements obtained from MRI. Subjects and Methods Twenty older adults, who were healthy and 20 people with chronic obstructive pulmonary disease (COPD), matched for age, sex, and body mass index, underwent MRI to obtain measurements of thigh muscle CSA and volume. Anthropometric measurements (skinfold thickness and thigh circumference) were used to estimate midthigh CSA. Results Muscle volumes were significantly lower in the people with COPD than in the older adults who were healthy. Moderate to high correlations were found between midthigh CSA and volume in both groups (r=.61-.94). Anthropometric measurements tended to overestimate midthigh CSA in both the people,with COPD (estimated CSA=64.9 +/- 17.8; actual CSA=48.3 +/- 10.2 cm(2)) and the older adults who were healthy (estimated quadriceps femoris muscle CSA=65.0 +/- 14.0; actual CSA=56.8 +/- 13.5 cm(2)). Furthermore, the estimated quadriceps femoris muscle CSAs were not sensitive enough to detect a difference in muscle size between people with COPD and controls. Thigh circumference alone was not different between groups and showed only low to moderate correlations with muscle volume (r=.19-.47). Discussion and Conclusion Muscle CSA measured from a single slice provides a good indication of volume, but the most representative slice should be chosen on the basis of the muscle group of interest. Thigh circumference is not correlated with muscle volume and, therefore, should not be used as an indicator of muscle size. The development of population-specific reference equations for estimating muscle CSA from anthropometric measurements is warranted.